Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $2,951.21 / $7,762.47	Facility		$776.25	$2,951.21	$7,762.47
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Facility	50	$5,011.87	$5,011.87	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $851.14 / $1,412.54	Professional		$144.54	$851.14	$1,412.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $223.87 / $4,265.80 / $9,549.93	Professional	50	$223.87	$4,265.80	$9,549.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,344.23 / $4,570.88	Facility		$1,348.96	$2,344.23	$4,570.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $776.25 / $1,318.26	Professional		$138.04	$776.25	$1,318.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
Christus Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $812.83 / $1,778.28	Professional		$162.18	$812.83	$1,778.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $4,466.84	Facility		$54.95	$56.23	$4,466.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,456.54 / $7,585.78 / $7,585.78	Professional		$6,456.54	$7,585.78	$7,585.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $1,380.38 / $5,248.07	Facility		$190.55	$1,380.38	$5,248.07
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Facility	50	$5,011.87	$5,011.87	$5,011.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $870.96 / $1,621.81	Professional		$147.91	$870.96	$1,621.81
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $223.87 / $223.87 / $5,495.41	Professional	50	$223.87	$223.87	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $6.03 / $2,691.53	Professional		$6.03	$6.03	$2,691.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $758.58 / $1,659.59	Facility		$141.25	$758.58	$1,659.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $794.33 / $1,737.80	Professional		$158.49	$794.33	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $616.60 / $1,548.82	Professional		$138.04	$616.60	$1,548.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $891.25 / $891.25	Professional		$851.14	$891.25	$891.25